New exercise effective for golfer’s elbow

August 14, 2014 — Researchers from the Nicholas Institute of Sports Medicine and Athletic Trauma in New York City found that a simple exercise using an inexpensive rubber bar is effective at reducing pain associated with medial epicondylosis, more commonly referred to as golfer’s elbow.

“The success and popularity of the ‘Tyler Twist’ led us to develop and evaluate an exercise for golfer’s elbow,” Timothy Tyler, PT, ATC, lead research author, said. “The ‘Tyler Twist,’ a novel exercise using the TheraBand FlexBar, was shown to significantly improve strength and reduce pain for individuals with chronic tennis elbow. This new golfer’s elbow exercise, dubbed the ‘Reverse Tyler Twist,’ also employs a FlexBar and was found to be effective at reducing the pain for patients suffering from golfer’s elbow.”

The study involved 20 patients with golfer’s elbow, a common condition that is characterized by pain on the inside of the elbow (medial epicondyle) and is aggravated by repetitive use of the wrist flexor muscles. As the diagnosis suggests, golfers are prone to medial elbow pain, but athletes in tennis, baseball, and weightlifting also suffer from the condition.

Eighteen of the 20 patients were competitive athletes, and 70 percent were golfers. All study participants had been unsuccessful in reducing their pain through conservative treatments such as medication, injections, and physical therapy.

Each participant received an average of 12 physical therapy sessions over a six-week period. The sessions consisted of stretching, ultrasound, massage, heat, and ice. In addition, they used a TheraBand FlexBar to perform the Reverse Tyler Twist for three sets of 15 repetitions with 60 seconds of rest between sets. On the days they didn’t have physical therapy, the patients performed the exercise twice a day until they felt discomfort.

The researchers used the Disability of Arm, Shoulder and Head (DASH) reporting scale to measure patient improvement. The DASH scale is a self-report questionnaire used by patients to rate their symptoms and ability to perform certain activities. The patients’ DASH scores markedly improved by 77 percent over the six-week study period.

The researchers concluded that the Reverse Tyler Twist, when prescribed at three sets of 15 repetitions daily over six weeks, appeared to be an effective treatment in the majority of patients who had already failed a previous intervention for the disorder.

“Additional benefits of this treatment are many,” Tyler said. “It can be performed as part of a home exercise program, it doesn’t involve continued medical supervision or expensive equipment, and treatment dosage is not limited by the patient needing to come to a clinic. All of these greatly reduce the costs associated with treatment.”

This clinical study, published in the International Journal of Sports Physical Therapy, adds further evidence that eccentric exercise can be effective for tendonopathies. Further research should evaluate longer term outcomes and compare the Reverse Tyler Twist to other therapies.